9/13/12 Ciprofloxacin: MedlinePlus Drug Information

Ciprofloxacin
(sip roe flox' a sin)

URL of this page: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html

IMPORTANT WARNING:

Taking ciprofloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a
bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during
your treatment or for up to several months afterward. These problems may affect tendons in your shoulder, your
hand, the back of your ankle, or in other parts of your body. Tendinitis or tendon rupture may happen to people of
any age, but the risk is highest in people over 60 years of age. Tell your doctor if you have or have ever had a
kidney, heart, or lung transplant; kidney disease; a joint or tendon disorder such as rheumatoid arthritis (a condition
in which the body attacks its own joints, causing pain, swelling, and loss of function); or if you participate in regular
physical activity. Tell your doctor and pharmacist if you are taking oral or injectable steroids such as
dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), or prednisone (Sterapred). If you experience any
of the following symptoms of tendinitis, stop taking ciprofloxacin, rest, and call your doctor immediately: pain,
swelling, tenderness, stiffness, or difficulty in moving a muscle. If you experience any of the following symptoms of
tendon rupture, stop taking ciprofloxacin and get emergency medical treatment: hearing or feeling a snap or pop in
a tendon area, bruising after an injury to a tendon area, or inability to move or to bear weight on an affected area.

Taking ciprofloxacin may worsen muscle weakness in people with myasthenia gravis (a disorder of the nervous
system that causes muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have
myasthenia gravis. Your doctor may tell you not to take ciprofloxacin. If you have myasthenia gravis and your doctor
tells you that you should take ciprofloxacin, call your doctor immediately if you experience muscle weakness or
difficulty breathing during your treatment.

Talk to your doctor about the risks of taking ciprofloxacin.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you
begin treatment with ciprofloxacin. Read the information carefully and ask your doctor or pharmacist if you have any
questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the
manufacturer's website to obtain the Medication Guide.

Why is this medication prescribed?

Ciprofloxacin is used to treat or prevent certain infections caused by bacteria. Ciprofloxacin is also used to treat or
prevent anthrax (a serious infection that may be spread on purpose as part of a bioterror attack) in people who may have
been exposed to anthrax germs in the air. Ciprofloxacin extended-release (long-acting) tablets are used only to treat
certain types of urinary tract infections. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by
killing bacteria that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

How should this medicine be used?

www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html 1/6
9/13/12 Ciprofloxacin: MedlinePlus Drug Information

Ciprofloxacin comes as a tablet, a suspension (liquid), and an extended-release tablet to take by mouth. The tablet and
suspension are usually taken twice a day, in the morning and evening, with or without food. The extended-release
tablets are usually taken once a day. Cipro XR brand extended-release tablets may be taken with or without food.
Proquin XR brand extended-release tablets should be taken with a main meal of the day, preferably the evening meal.
Take ciprofloxacin at around the same time(s) every day. The length of your treatment depends on the type of infection
you have. Your doctor will tell you how long to take ciprofloxacin. Follow the directions on your prescription label
carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ciprofloxacin exactly as
directed. Do not take more or less of it or take it more often than prescribed by your doctor.

One brand or type of ciprofloxacin cannot be substituted for another. Be sure that you receive only the brand or type of
ciprofloxacin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of
ciprofloxacin you were given.

Do not take ciprofloxacin with dairy products or calcium-fortified juices alone. However, you may take ciprofloxacin with
a meal that includes these foods or drinks.

Swallow the tablets whole; do not split, crush, or chew them. If you cannot swallow tablets whole, tell your doctor.

If you are taking the suspension, shake the bottle very well for 15 seconds before each use to mix the medication
evenly. Swallow the correct dose without chewing the granules in the suspension. Close the bottle completely after each
use. Do not give the suspension to a patient through a feeding tube.

You should begin feeling better during the first few days of your treatment with ciprofloxacin. If your symptoms do not
improve or if they get worse, call your doctor. If you are being treated for a urinary tract infection, call your doctor if you
develop fever or back pain during or after your treatment. These symptoms may be signs that your infection is
worsening.

Take ciprofloxacin until you finish the prescription, even if you feel better. Do not stop taking ciprofloxacin unless you
experience the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING section or the
symptoms of allergic reaction described in the SIDE EFFECTS section. If you stop taking ciprofloxacin too soon or if
you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Other uses for this medicine

In the event of biological warfare, ciprofloxacin may be used to treat and prevent dangerous illnesses that are
deliberately spread such as plague, tularemia, and anthrax of the skin or mouth. Talk to your doctor about the risks of
using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking ciprofloxacin,
tell your doctor and pharmacist if you are allergic or have had a severe reaction to ciprofloxacin; any other
quinolone or fluoroquinolone antibiotic such as gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin
(Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin) (not available in the U.S.), moxifloxacin (Avelox),
nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), and sparfloxacin (Zagam) (not available in the
U.S.); or any other medications, or if you are allergic to any of the ingredients in ciprofloxacin tablets or
suspension. Ask your doctor or pharmacist for a list of the ingredients.
tell your doctor if you are taking tizanidine (Zanaflex). Your doctor will probably tell you not to take ciprofloxacin
while you are taking this medication.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional
supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in
www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html 2/6
9/13/12 Ciprofloxacin: MedlinePlus Drug Information

the IMPORTANT WARNING section and any of the following: anticoagulants ('blood thinners') such as warfarin
(Coumadin, Jantoven); certain antidepressants; antipsychotics (medications to treat mental illness); caffeine or
medications that contain caffeine (Excedrin, NoDoz, Vivarin, others); clozapine (Clozaril, Fazaclo); cyclosporine
(Gengraf, Neoral, Sandimmune); diuretics ('water pills'); glyburide (DiaBeta, in Glucovance, Micronase, others);
certain medications for irregular heartbeat such as amiodarone (Cordarone), disopyramide (Norpace),
procainamide (Procanbid), quinidine, and sotalol (Betapace, Betapace AF, Sorine); methotrexate (Rheumatrex,
Trexall); metoclopramide (Reglan); certain nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
(Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); phenytoin (Dilantin, Phenytek); probenecid (in Col-
Probenecid, Probalan); ropinirole (Requip); or theophylline (Elixophyllin, Theo-24, Uniphyl, others). Your doctor
may need to change the doses of your medications or monitor you carefully for side effects. Many other
medications may also interact with ciprofloxacin, so be sure to tell your doctor about all the medications you are
taking, even those that do not appear on this list.
if you are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums,
others); didanosine (Videx); calcium, iron, zinc, or vitamin supplements; or sucralfate (Carafate), you will need to
allow some time to pass between when you take a dose of any of these medications and when you take a dose
of ciprofloxacin. Ask your doctor or pharmacist how many hours before or after you take ciprofloxacin you may
take these medications.
tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem
that may cause irregular heartbeat, fainting, or sudden death) or an irregular heartbeat, and if you have or have
ever had nerve problems, a low level of potassium in your blood, cerebral arteriosclerosis (narrowing of blood
vessels in or near the brain that can lead to stroke or ministroke), seizures, or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while
taking ciprofloxacin, call your doctor.
you should know that ciprofloxacin may cause confusion, dizziness, lightheadedness, and tiredness. Do not drive
a car, operate machinery or participate in activities requiring alertness or coordination until you know how this
medication affects you.
plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds and sunlamps) and
to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin may make your skin sensitive to sunlight
or ultraviolet light. If your skin becomes reddened, swollen, or blistered, like a bad sunburn, call your doctor.

What special dietary instructions should I follow?

Do not drink or eat a lot of caffeine-containing products such as coffee, tea, energy drinks, cola, or chocolate.
Ciprofloxacin may increase nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine.

Make sure you drink plenty of water or other fluids every day while you are taking ciprofloxacin.

What should I do if I forget a dose?

If you miss a dose of ciprofloxacin, take the missed dose as soon as you remember it. However, if it is almost time for
the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up
for a missed one.Do not take more than two doses of the tablets or suspension or more than one dose of the extended-
release tablets in one day.

What side effects can this medication cause?

Ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go
away:
nausea

vomiting

www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html 3/6
9/13/12 Ciprofloxacin: MedlinePlus Drug Information

stomach pain

heartburn

diarrhea

feeling an urgent need to urinate

headache

vaginal itching and/or discharge

Some side effects can be serious. If you experience any of these symptoms, or those mentioned in the
IMPORTANT WARNING section, stop taking ciprofloxacin and call your doctor immediately:
severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur
up to 2 months or more after your treatment)

rash or blisters

hives

itching

tingling or swelling of the face, neck, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

difficulty breathing or swallowing

hoarseness or throat tightness

wheezing

rapid, irregular, or pounding heartbeat

fainting

fever

joint or muscle pain

unusual bruising or bleeding

extreme tiredness

lack of energy

loss of appetite

pain in the upper right part of the stomach

yellowing of the skin or eyes

dark urine

flu-like symptoms

seizures

dizziness

confusion

nervousness

www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html 4/6
9/13/12 Ciprofloxacin: MedlinePlus Drug Information

restlessness

anxiety

difficulty falling asleep or staying asleep

nightmares or abnormal dreams

not trusting others or feeling that others want to hurt you

hallucinations (seeing things or hearing voices that do not exist)

depression

thoughts about dying or killing yourself

uncontrollable shaking of a part of the body

pain, burning, tingling, numbness, and/or weakness in a part of the body

Ciprofloxacin may cause problems with bones, joints, and tissues around joints in children. Ciprofloxacin should not
normally be given to children younger than 18 years of age unless they have certain serious infections that cannot be
treated with other antibiotics or they have been exposed to anthrax in the air. If your doctor prescribes ciprofloxacin for
your child, be sure to tell the doctor if your child has or has ever had joint-related problems. Call your doctor if your child
develops joint problems such as pain or swelling while taking ciprofloxacin or after treatment with ciprofloxacin. Talk to
your child's doctor about the risks of giving ciprofloxacin to your child.

Ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this
medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's
(FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-
332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets and
extended-release tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the
suspension in the refrigerator or at room temperature, closed tightly, for up to 14 days. Do not freeze ciprofloxacin
suspension. Throw away any suspension that is left over after 14 days and any medication that is outdated or no longer
needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not
breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's
response to ciprofloxacin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of
infection after you finish taking ciprofloxacin, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you

www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html 5/6
9/13/12 Ciprofloxacin: MedlinePlus Drug Information

are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list
with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with
you in case of emergencies.

Brand names

Cipro® Cipro XR® Proquin XR®

Last Revised - 06/15/2011

American Society of Health-System Pharmacists, Inc. Disclaimer

AHFS® Consumer Medication Information. © Copyright, 2012. The American Society of Health-System Pharmacists, Inc., 7272
Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

www.nlm.nih.gov/medlineplus/druginfo/meds/a688016.html 6/6